Monday, September 14, 2009

The Health of Britain, Part IV

It was always going to be expensive to create a healthcare system for all that was free at the point of service, but not even the NHS founding fathers could have realised what an economic colossus it would eventually become.

In 1948 the service had a budget of £437 million, about £9 billion today. Each year since, this figure has climbed by more than the rate of inflation, last year the budget topping £100 billion -- more than £1,500 for every man, woman and child in the country. Sixty per cent of this goes on staff and 20 per cent on drugs.

The NHS, with its 1.5 million employees, has become the largest employer in the world after Wal-Mart, Indian Railways and the Chinese People’s Liberation Army. . .

Accounting for, roughly, 18 per cent of all government spending, the NHS is enormous, expensive -- and still growing.

The NHS may need to cut its workforce by about 10 per cent -- the equivalent of 137,000 staff -- to help to meet planned savings of £20 billion, according to a leaked Department of Health report.

A study commissioned from the consultancy firm McKinsey and Company recommends cutting clinical staff posts as well as administrators to meet efficiency savings by 2014, suggesting a knock-on effect to patient care. . .

The report also said that if four million of the 29 million outpatient appointments each year could be cut, it would save £600 million.

A further £700 million could be saved if procedures with limited clinical benefits -- such as tonsillectomies, varicose vein removal and some hysterectomies -- were no longer performed.

Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors have warned.

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.

But this approach can also mask the signs that their condition is improving, the experts warn.